Psychiatric decision making in the adoption of a new antipsychotic in Germany

Objective: Studies in somatic medicine have demonstrated delays in the implementation of new drugs, but data on psychiatric drugs are scarce. This study examined psychiatrists' adoption of a new antipsychotic. Methods: A prospective survey of 50 hospital psychiatrists in Germany was conducted three months before and three months after the market introduction of aripiprazole. Psychiatrists' awareness and perceptions of the drug and psychiatrist-related data were obtained before the launching of aripiprazole; actual prescription patterns were recorded afterward. Results: Predictors of major concerns about the credibility of statements related to efficacy or tolerability of the drug were older age and longer work experience of the psychiatrists. Three months after market introduction, 79 percent of the psychiatrists had already prescribed the new antipsychotic. Predictors for early adoption were older age, being responsible for patients with mild mental illness, and having a higher tolerance of uncertainty. Conclusions: Despite concerns as to the credibility of statements about aripiprazole's efficacy and tolerability, the psychiatrists were found to be early adopters of the new compound. The predictors identified for early adoption show the importance of physician-related factors for the quality of everyday care.